Shin Young Seob, Yoon Yong Sik, Lim Seok-Byung, Yu Chang Sik, Kim Tae Won, Chang Heung Moon, Park Jin-Hong, Ahn Seung Do, Lee Sang-Wook, Choi Eun Kyung, Kim Jin Cheon, Kim Jong Hoon
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Radiat Oncol J. 2016 Sep;34(3):177-185. doi: 10.3857/roj.2016.01872. Epub 2016 Sep 28.
To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients.
Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months.
All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting.
PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.
探讨术前放化疗（PCRT）后行局部切除（LE）在临床T2N0直肠癌患者中是否为可行的治疗方法。
回顾性分析2006年1月至2014年6月间因距肛缘7 cm以内的临床T2直肠癌接受PCRT和LE的患者。若PCRT后临床反应良好，则行LE。在中位随访49个月时，对患者的特征、治疗记录、肿瘤复发及治疗相关并发症进行评估。
所有患者均接受经肛门切除或经肛门微创手术。34例患者中，19例（55.9%）出现病理完全缓解（pCR）。3年局部无复发生存率和无病生存率分别为100.0%和97.1%。pCR患者中无复发情况。除1例4级肠膀胱瘘外，所有其他晚期并发症均较轻且为自限性。
对于临床T2N0低位直肠癌且反应良好的患者，PCRT后行LE可能是全直肠系膜切除的一种可行替代方法。
